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Jacob E, Smucker L, Crouse R, Allard-Picou A. Isolated brachioradialis metastasis of gastric adenocarcinoma after R0 resection. World J Surg Oncol 2021; 19:83. [PMID: 33743738 PMCID: PMC7981802 DOI: 10.1186/s12957-021-02191-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gastric cancer is the fifth most common cancer worldwide, with an incidence of 6.72 per 100,000 people. Thirty-two percent of gastric cancer patients will live 5 years after diagnosis. Single-site metastasis is noted in 26% of patients with gastric cancer, most commonly in the liver (48%), peritoneum (32%), lung (15%), and bone (12%). Here, a case is presented in which a single skeletal muscle metastasis appeared after appropriate resection and treatment. CASE PRESENTATION A 63-year-old man underwent neoadjuvant chemotherapy and a multivisceral en bloc R0 resection. Final pathology showed no evidence of lymph node metastasis with 31 negative lymph nodes. Four months postoperatively, the patient was found to have a rapidly growing biopsy-proven extremity soft tissue gastric metastasis within the brachioradialis muscle. He subsequently underwent metastasectomy and immunotherapy. CONCLUSION This case is a rare example of an isolated extremity metastasis of gastric adenocarcinoma in the setting of an R0 resection of the primary tumor and negative nodal disease on final pathology, suggestive of hematogenous spread. We review the biology, workup, and management of gastric cancer and highlight new advancements in the treatment of this aggressive cancer.
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Affiliation(s)
- Elizabeth Jacob
- Department of Surgery, Bassett Medical Center, Cooperstown, NY, USA
| | - Levi Smucker
- Department of Surgery, Bassett Medical Center, Cooperstown, NY, USA.
| | - Ryan Crouse
- Department of Surgery, Bassett Medical Center, Cooperstown, NY, USA
| | - Ayana Allard-Picou
- Department of Surgery, Bassett Medical Center, Cooperstown, NY, USA
- Columbia University College of Physicians and Surgeons, New York City, USA
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2
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Aguirre LE, Salcedo J, Zuquello R, Garcia-Buitrago M, Ardalan B. Metastatic involvement of skeletal muscle from gastric adenocarcinoma. Oxf Med Case Reports 2019; 2019:omz081. [PMID: 31772748 PMCID: PMC6736074 DOI: 10.1093/omcr/omz081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/04/2019] [Accepted: 07/14/2019] [Indexed: 12/09/2022] Open
Abstract
Gastric cancer represents the fifth most common cancer diagnosis worldwide and the third leading cause of cancer-related mortality. In the USA, the overall 5-year survival rate is 31%, with distant disease nearing 5%. The most common sites of metastasis are the liver and peritoneum. Skeletal muscle involvement has been rarely reported. Since clinical and imaging findings overlap with primary sarcomas, a confirmatory biopsy is required for diagnosis. Prognosis remains poor with treatment options including palliative chemotherapy, radiotherapy and surgical resection. We report the case of a 57-year-old female presenting with extensive involvement of skeletal muscle 10 years after achieving remission. In addition to illustrating the refractoriness and poor outcomes associated with muscle involvement, this case and comprehensive review of the literature highlights important characteristics of disease biology and tumor genomics that warrant detailed discussion and exposition to a wider audience.
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Affiliation(s)
- L E Aguirre
- Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, USA
| | - J Salcedo
- Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, USA
| | - R Zuquello
- Department of Internal Medicine, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, USA
| | - M Garcia-Buitrago
- Department of Pathology, University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, USA
| | - B Ardalan
- Department of Hematology/Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
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Choi CK, Kweon SS, Lee YH, Nam HS, Park KS, Ryu SY, Choi SW, Kim SA, Shin MH. Nonlinear association between bone mineral density and all-cause mortality: the Dong-gu study. Osteoporos Int 2018; 29:2011-2020. [PMID: 30014158 DOI: 10.1007/s00198-018-4386-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/04/2018] [Indexed: 11/28/2022]
Abstract
UNLABELLED There was a U-shaped association between hip BMD and all-cause mortality, with the lowest mortality in the 90th percentile in males. However, there was an inverse linear relationship in females. In contrast, the association between lumbar spine BMD and mortality was less evident in males, with no association in females. INTRODUCTION Bone mineral density (BMD) is reported inversely associated with mortality. Although some previous studies provided evidence for nonlinear associations, these were not adequately assessed in most previous works. METHODS We evaluated the nonlinear relationship between BMD and mortality in Asians. Our study involved 8629 participants in the Dong-gu study from 2007 to 2010. Cox proportional hazard regression was used to calculate hazard ratios (HRs) according to BMD categories after adjusting for potential confounders. During a follow-up of 6.7 ± 1.4 years, 712 participants died. RESULTS There was a U-shaped association between hip BMD and all-cause mortality, with the lowest mortality in the 90th percentile in males. However, there was an inverse linear relationship in females. In males, compared with the 75th to 95th percentile group, the < 2.5th percentile group had a 3.89 (95% CI 2.41-6.28)-fold higher risk and the 2.5th to 5th percentile group had a 2.51 (95% CI 1.25-5.04)-fold higher risk. The HR was 2.51 (95% CI 1.25, 5.04) in the > 97.5th percentile group. In females, compared with that in the 75th to 95th percentile group, the HR was 2.33 (95% CI 1.24, 4.39) in the < 2.5th percentile group. In contrast, the association between lumbar spine BMD and mortality was less evident in males, with no association in females. CONCLUSION In conclusion, this study shows that the association between BMD and mortality varies by gender and that high and low BMD are predictors of all-cause mortality in males.
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Affiliation(s)
- C K Choi
- Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun-gun, Gwangju, Jeollanam-do, 58128, Korea
| | - S -S Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun-gun, Gwangju, Jeollanam-do, 58128, Korea
| | - Y -H Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Republic of Korea
| | - H -S Nam
- Department of Preventive Medicine, Chungnam National University Medical School, Daejeon, Republic of Korea
| | - K -S Park
- Cardiocerebrovascular Center, Mokpo Jung-Ang Hospital, Mokpo, Republic of Korea
| | - S -Y Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
| | - S -W Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea
| | - S A Kim
- Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun-gun, Gwangju, Jeollanam-do, 58128, Korea
| | - M -H Shin
- Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun-gun, Gwangju, Jeollanam-do, 58128, Korea.
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Okazaki J, Muguruma N, Kitamura S, Kimura T, Okamoto K, Miyamoto H, Kishi K, Bando Y, Kondo T, Endo I, Abe M, Takayama T. Paraneoplastic Hypocalcemia Developed in Gastric Cancer Accompanied by Osteoblastic Metastasis. Intern Med 2017; 56:1345-1349. [PMID: 28566596 PMCID: PMC5498197 DOI: 10.2169/internalmedicine.56.8545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Paraneoplastic syndromes are generally defined as clinical disorders associated with malignant diseases, and hypocalcemia associated with cancer is a rare condition. A woman in her 60s was referred to our hospital for the further examination of massive ascites due to carcinoma of unknown primary origin. She complained of numbness around her lips, and marked hypocalcemia of 5.0 mg/dL was noted. After two courses of chemotherapy, computed tomography showed a decrease in the ascites, and her serum calcium level increased. Although hypocalcemia is a very rare condition in patients with gastric cancer, serum calcium values should be evaluated when neurological symptoms are observed.
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Affiliation(s)
- Jun Okazaki
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Naoki Muguruma
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Shinji Kitamura
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Tetsuo Kimura
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Koichi Okamoto
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Hiroshi Miyamoto
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Kazuhiro Kishi
- Department of Gastroenterology, National Hospital Organization Higashi Tokushima Hospital, Japan
| | - Yoshimi Bando
- Division of Pathology, Tokushima University Hospital, Japan
| | - Takeshi Kondo
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Itsuro Endo
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Masahiro Abe
- Department of Hematology, Endocrinology and Metabolism, Tokushima University Graduate School of Biomedical Sciences, Japan
| | - Tetsuji Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School of Biomedical Sciences, Japan
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Koga Y, Baba Y, Harada K, Kosumi K, Shigaki H, Kurashige J, Ishimoto T, Iwatsuki M, Miyamoto Y, Sakamoto Y, Yoshida N, Baba H. Multiple skeletal muscle metastases from poorly differentiated gastric adenocarcinoma. Surg Case Rep 2015; 1:105. [PMID: 26943429 PMCID: PMC4607684 DOI: 10.1186/s40792-015-0108-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/08/2015] [Indexed: 01/08/2023] Open
Abstract
We report here a rare case of gastric carcinoma with multiple intramuscular metastases. A 71-year-old man presented with rapidly evolving swelling of his left thigh and severe pain. Three years earlier, he had undergone neoadjuvant chemotherapy followed by gastrectomy for advanced gastric cancer. A computed tomography scan showed unusual swellings in multiple skeletal muscles with no vessel or bone invasion. Importantly, the affected muscles did not contain distinct masses but were diffusely enlarged. Pathological examination of an open muscle biopsy showed a poorly differentiated adenocarcinoma, supporting a diagnosis of gastric cancer metastases in multiple skeletal muscles.
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Affiliation(s)
- Yuki Koga
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Yoshifumi Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Kazuto Harada
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Keisuke Kosumi
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Hironobu Shigaki
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Junji Kurashige
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Takatsugu Ishimoto
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Masaaki Iwatsuki
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Yuji Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Yasuo Sakamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Naoya Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Kumamoto, 860-8556, Japan.
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Basheer A, Daniel J, Padhi S. Compressive myeloradiculopathy from bony metastasis as the initial presentation of poorly differentiated adenocarcinoma stomach - a case report. Australas Med J 2013; 6:515-9. [PMID: 24223069 DOI: 10.4066/amj.2013.1859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Carcinoma of the stomach rarely disseminates to bone. We report a case of compressive myeloradiculopathy from extensive metastases to the spine, which on evaluation originated from adenocarcinoma of the stomach. Magnetic resonance imaging of the spine showed osteolytic and osteosclerotic metastases. Gastrointestinal endoscopy revealed ulcerative growth in the stomach that on biopsy showed poorly differentiated adenocarcinoma. This case is unique in that the initial presentation of gastric cancer itself was bony metastases without any gastrointestinal symptoms or liver involvement. Moreover, metastases were osteosclerotic as well, which is against the general belief that gastric cancer produces only osteolytic secondaries.
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Affiliation(s)
- Aneesh Basheer
- Department of Medicine, Pondicherry Institute of Medical Sciences
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7
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Gregson CL, Hardcastle SA, Cooper C, Tobias JH. Friend or foe: high bone mineral density on routine bone density scanning, a review of causes and management. Rheumatology (Oxford) 2013; 52:968-85. [PMID: 23445662 DOI: 10.1093/rheumatology/ket007] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
A finding of high BMD on routine DXA scanning is not infrequent and most commonly reflects degenerative disease. However, BMD increases may also arise secondary to a range of underlying disorders affecting the skeleton. Although low BMD increases fracture risk, the converse may not hold for high BMD, since elevated BMD may occur in conditions where fracture risk is increased, unaffected or reduced. Here we outline a classification for the causes of raised BMD, based on identification of focal or generalized BMD changes, and discuss an approach to guide appropriate investigation by clinicians after careful interpretation of DXA scan findings within the context of the clinical history. We will also review the mild skeletal dysplasia associated with the currently unexplained high bone mass phenotype and discuss recent advances in osteoporosis therapies arising from improved understanding of rare inherited high BMD disorders.
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Affiliation(s)
- Celia L Gregson
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK.
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8
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Pinto-Lopes P, Fonseca FA, Silva R, Hafe PV, Fonseca E. Indolent systemic mastocytosis limited to the bone: a case report and review of the literature. SAO PAULO MED J 2013; 131:198-204. [PMID: 23903270 PMCID: PMC10852104 DOI: 10.1590/1516-3180.2013.1313460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 01/29/2012] [Accepted: 09/21/2012] [Indexed: 01/08/2023] Open
Abstract
CONTEXT Systemic mastocytosis is defined as a clonal disorder of mast cells and their precursor cells and is currently classified as a myeloproliferative neoplasm. Its clinical course has a wide spectrum, ranging from indolent disease, with normal life expectancy, to highly aggressive disease, associated with multisystemic involvement and poor overall survival. The aim of this study was to report a case of indolent systemic mastocytosis, focusing on the diagnostic challenges, with a review of the literature. CASE REPORT A 79-year-old Caucasian woman with osteoporosis was evaluated at the Emergency Department because of complaints of low back pain. Before this, she had consulted an orthopedist and had undergone some imaging examinations, namely a bone scan that revealed a "superscan" pattern. Due to her pain complaints and these test results, the patient was admitted to the Department of Internal Medicine. After undergoing several analytical tests and some additional imaging examinations to rule out some important differential diagnoses, she then underwent bone marrow biopsy, which made it possible to identify indolent systemic mastocytosis. CONCLUSION Systemic mastocytosis is a rare entity that is difficult to diagnose. Its symptoms are often unspecific and frequently ignored. Skeletal changes may be the first and only manifestation of the disease and in some cases, like this one, the diagnosis is made only after histological examination. The key point for the diagnosis is to contemplate the possibility of systemic mastocytosis.
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9
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Hekmat S, Ghaedian T, Barati H, Movahed M. Solitary metastasis of gastric cancer to fibula: a case report. IRANIAN JOURNAL OF RADIOLOGY 2012; 9:161-4. [PMID: 23329984 PMCID: PMC3522377 DOI: 10.5812/iranjradiol.3564] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 01/31/2012] [Accepted: 02/15/2012] [Indexed: 12/17/2022]
Abstract
Gastric cancer is one of the most common and most fatal neoplasms in human. Its skeletal metastasis is less frequent, particularly when solitary. The objective of this article is to represent a case of solitary fibular metastasis from this cancer not reported before based on Medline search.
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Affiliation(s)
- Sepideh Hekmat
- Department of Nuclear Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author: Sepideh Hekmat, Hasheminejad Hospital, Tehran, Iran. Tel.: +98-9123049589, Fax: +98-2188644471, E-mail:
| | - Tahereh Ghaedian
- Department of Nuclear Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Barati
- Department of Nuclear Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansour Movahed
- Department of Nuclear Medicine, Hasheminejad Hospital, Tehran University of Medical Sciences, Tehran, Iran
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10
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Gómez Herrera J, Hernández Aceituno D, Calero García R. Aumento de tamaño muscular secundario a metástasis de adenocarcinoma gástrico no conocido. Rev Esp Cir Ortop Traumatol (Engl Ed) 2010. [DOI: 10.1016/j.recot.2010.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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11
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Diffuse skeletal muscle metastasis from gastric cancer similar to inflammatory disease: a report of two patients. CURRENT ORTHOPAEDIC PRACTICE 2010. [DOI: 10.1097/bco.0b013e3181c84691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Increase in muscle mass secondary to metastasis of an unknown gastric adenocarcinoma. Rev Esp Cir Ortop Traumatol (Engl Ed) 2010. [DOI: 10.1016/s1988-8856(10)70268-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Skeletal muscle metastases: primary tumours, prevalence, and radiological features. Eur Radiol 2009; 20:649-58. [PMID: 19707767 DOI: 10.1007/s00330-009-1577-1] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Revised: 07/21/2009] [Accepted: 07/25/2009] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although skeletal muscles comprise nearly 50% of the total human body mass and are well vascularised, metastases in the musculature are rare. The reported prevalence of skeletal muscle metastases from post-mortem studies of patients with cancer is inconstant and ranges from 0.03 to 17.5%. MATERIALS AND METHODS Of 5,170 patients with metastasised cancer examined and treated at our institution during the period from January 2000 to December 2007, 61 patients with muscle metastases (80 lesions) were identified on computed tomography (CT). Genital tumours (24.6%) were the most frequent malignancies metastasising into the skeletal musculature, followed by gastrointestinal tumours (21.3%), urological tumours (16.4%), and malignant melanoma (13.1%). Other primary malignancies were rarer, including bronchial carcinoma (8.2%), thyroid gland carcinoma (4.9%), and breast carcinoma (3.3%). In 8.2%, carcinoma of unknown primary was diagnosed. RESULTS Skeletal muscle metastases (SMM) were located in the iliopsoas muscle (27.5%), paravertebral muscles (25%), gluteal muscles (16.3%), lower extremity muscles (12.5%), abdominal wall muscles (10%), thoracic wall muscles (5%), and upper extremity muscles (3.8%). Most (76.3%) of the 80 SMM were diagnosed incidentally during routine staging CT examinations, while 23.7% were symptomatic. CONCLUSION Radiologically, SMM presented with five different types of lesions: focal intramuscular masses (type I, 52.5% of SMM), abscess-like intramuscular lesions (type II, 32.5%), diffuse metastatic muscle infiltration (type III, 8.8%), multifocal intramuscular calcification (type IV, 3.7%) and intramuscular bleeding (type V, 2.5%).
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Beşe NS, Ozgüroğlu M, Dervişoğlu S, Kanberoğlu K, Ober A. Skeletal muscle: an unusual site of distant metastasis in gastric carcinoma. ACTA ACUST UNITED AC 2006; 24:150-3. [PMID: 16715679 DOI: 10.1007/bf02493284] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
UNLABELLED Gastric cancer metastatic to skeletal muscle is an unusual entity. Surgery, systemic chemotherapy, or radiotherapy to the metastatic mass can be treatment options for achiving palliation. CASE REPORT A patient with multiple skeletal muscle metastases that occurred during follow-up after gastrectomy and adjuvant chemo-radiotherapy is reported. Magnetic resonance imaging (MRI) demonstrated soft-tissue masses involving the posterior right paralumbar and posterior left paradorsal muscles. Biopsy showed metastatic infiltrating adenocarcinoma. The patient did not respond to palliative chemotherapy. Palliative radiotherapy was administered to the painful mass. Based on this case, the diagnosis of muscle metastases and treatment options for palliation are discussed.
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Affiliation(s)
- Nuran Senel Beşe
- Department of Radiation Oncology, Cerrahpasa Medical School, Istanbul University, Turkey
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16
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Anastasovska V, Balagué F, Waldburger M. Muscular metastatic infiltration from pulmonary epidermoid carcinoma. Joint Bone Spine 2002; 69:412-5. [PMID: 12184441 DOI: 10.1016/s1297-319x(02)00422-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The localisation of metastasis in muscle is rare and is discovered mainly during autopsy. Skeletal muscle metastasis may occur in the case of leukaemia, lymphoma, melanoma, thyroid, gastrointestinal tract and breast carcinoma. However the most frequent aetiology is lung cancer. We describe the case of a 67-year-old woman, suffering from epidermoid lung carcinoma localised in both upper right lobes, treated surgically with success. Two months after surgery, she complained of pain and a sensation of swelling in the adductor muscles of the left hip with important restriction of mobility. A MRI scan of the hip showed an ovoid mass between the obturator extemus and the adductors muscles on the left side. Biopsy of the infiltrated muscles showed proliferation of carcinomatous tissue.
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Affiliation(s)
- Valerija Anastasovska
- Department of Rheumatology, Physical Medicine and Rehabilitation, Hĵpital Cantonal, Fribourg, Switzerland
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Escuissato DL, Ledesma JA, Urban LABD, Liu CB, Reis Filho JS, Oliveira Filho AG, Ferri MB, Hossaka MA. Metástase de câncer gástrico simulando neoplasia primária de pulmão: relato de caso e revisão da literatura. Radiol Bras 2002. [DOI: 10.1590/s0100-39842002000200015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O adenocarcinoma gástrico apresenta, freqüentemente, disseminação por extensão direta para órgãos vizinhos. Metástases para sítios distantes, como o pulmão, são menos freqüentes, sugerindo usualmente outras doenças. O objetivo deste artigo é apresentar o caso de um paciente de 47 anos de idade, cujos exames de imagem (radiografias simples e tomografia computadorizada de tórax) apresentaram características sugestivas de neoplasia pulmonar primária e com diagnóstico simultâneo de câncer gástrico evidenciado pela endoscopia digestiva alta. A biópsia, guiada por fibrobroncoscopia, da massa torácica confirmou o diagnóstico de metástase pulmonar de adenocarcinoma gástrico. Além da apresentação do caso, é feita uma revisão do padrão de disseminação do câncer gástrico.
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18
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Calvillo O, Skaribas I, Turnipseed J. Anatomy and pathophysiology of the sacroiliac joint. CURRENT REVIEW OF PAIN 2000; 4:356-61. [PMID: 10998744 DOI: 10.1007/s11916-000-0019-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The sacroiliac joint as a source of chronic pain has been a subject of debate for a long period of time. This controversy stems from the inherent anatomic location of the sacroiliac joint. Adjacent spinal structures may cause pain to be referred to the sacroiliac joint, thus making a precise diagnosis difficult. The most reliable method to establish the diagnosis of sacroiliac arthralgia is fluoroscopic-guided intra-articular injection of a local anesthetic preceded by a sacroiliac arthrogram. Although there are many therapeutic options for sacroiliac joint syndrome, the ideal treatment has not yet been discovered. There is evidence that intra-articular viscosupplementation of the sacroiliac joint with hylan can consistently and reliably induce a prolonged analgesic response in sacroiliac joint syndrome. Viscosupplementation restores joint homeostasis, allows increased joint motion, and induces analgesia. Hylan is highly viscoelastic hyaluronan (hyaluronic acid), and is capable of increasing the viscoelastic properties of synovial fluid.
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Affiliation(s)
- O Calvillo
- Center for Pain Medicine, Department of Anesthesiology, Baylor College of Medicine, 6560 Fannin, Suite 1900, Houston, TX 77030, USA.
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